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Thursday, November 3, 2011

If You Don't Want to Buy One, Don't Try One: Recovery Pump Review

While my race performance at Rev3 South Carolina was a bit of a mixed bag, one thing that was unambiguously great about the experience was that, at the expo, I had the chance to try out new product called the Recovery Pump. Experienced triathletes (and athletes in any sport) recognize that proper recovery from workouts and races is nearly as important as the workouts and races themselves, because it's only during the recovery phase that one actually gets stronger as the body overcompensates for the stress that it's experienced. With three sports to account for, triathletes as a rule train too much and recover too little, thereby often experiencing overuse injuries and performance levels that plateau for long periods.

While triathletes are loathe to take time off of training, they're much more willing to consider methods that accelerate the recovery process. The traditional method is, of course, the dreaded ice bath, whereby one fills a bathtub with icy water and sits in it for 15 or 20 minutes. The theory is that the cold reduces inflammation and also draws blood to the chilled areas, which aids recovery by flushing out lactic acid and other pernicious byproducts of hard training. Although many athletes swear by ice baths, the downsides are obvious: they're very painful, and also inconvenient. You need a bathtub, a large quantity of ice, 20-30 minutes to spare, and you can't take them anywhere. Ice baths after cold winter runs are a particularly unwelcome proposition.

The second traditional rapid-recovery strategy is the massage. Especially popular immediately post-race, massages can work wonders, but for most athletes, they're reserved for rare occasions due to the cost (often as much as $80/hour before tip) and time-consuming nature of the visit itself.

The final established rapid-recovery strategy has involved the use of compression garments, such as tights and calf sleeves. The best of these garments use graded compression, i.e., they squeeze most strongly at the foot, less around the mid-leg, and least around the quad, such that blood is forced up out of the leg and inflammation is reduced. Compression tights are great, and certainly warrant a place in every athlete's wardrobe.

The Recovery Pump is a new, FDA-approved, prescription-only product that essentially combines most of the benefits of all three strategies listed above, while minimizing the inconveniences. In essence, the pump system is a pair of inflatable boots that cover from the tip of the toes to the base of the glutes, and an adjustable air compressor that progressively inflates the boots from the bottom up, releases the air, and repeats the process. In Recovery Pump's lingo, it's an SIPC, or "Sequential Intermittent Pneumatic Compression" device.

Each boot is connected by pneumatic tubes (they look like white wires, but are hollow) to the very small compressor box to the right of the picture. Each boot contains four chambers: one around the foot and ankle, the next around the soleus and calf muscles, the third around the knee and lower quads, and the fourth around the quads and lower glutes. The lower-most chamber inflates first, followed by the calf, knee, and quad chambers. The inflation is held for a few seconds, and then all four chambers deflate simultaneously with a minor "whoosh," and there's a palpable feeling of blood rushing down your legs into your feet. Then they inflate sequentially once more, and the process repeats itself. Both the intensity of the compression, and the "deflated" time between compression sequences, can be adjusted easily using dials on the compressor.

You might think that pneumatic -- or "air pressure" -- compression wouldn't feel like much. But you'd be very wrong. The closest analogy I can draw is to the strength of a blood pressure cuff: imagine four cuffs that, together, cover your whole leg, and that automatically inflate and release. I can't imagine many people wanting stronger compression than you get on the highest compression setting.

The end result of the compression and deflation sequence is that blood is pushed progressively out of your beaten-up legs, and then rushes back in, and out, and in again. This is exactly what compression garments attempt to do, but their compression is clearly weaker than the Recovery Pump, and it's obviously not cyclical.

The most obvious thing to say about the Recovery Pump is that it feels absolutely, positively wonderful. At the Rev3 expo tent, people would park themselves in the boots and essentially decide to stay there indefinitely. In the two weeks I've had the boots, I've done some very serious workouts, and it's gotten to the point where, afterward, my main objective is to shower and get some food as quickly as possible so that I can collapse onto my couch with the boots and bliss out. They are utterly relaxing in the way that a gentle massage is, and my legs feel just terrific after I use them.

Feeling great is one thing, but an obvious question is, do they facilitate recovery? Here's how the Recovery Pump folks explain the benefits: "When the athlete stops exercising, venous return decreases significantly, slowing the evacuation of Lactic Acid, Carbon Dioxide, other Metabolic Waste and water. The challenge is to continue the process of clearing these elements after exercise has stopped so as to NOT allow the accumulation of these waste to sit in the muscle for long periods of time. By clearing these elements quickly, better O2 perfusion occurs as does the delivery of plasma through capillary action of blood flow. Plasma and O2 are the lifeblood of healthy cells. The more cells get, the healthier they are. The accumulation of Lactic Acid, Carbon Dioxide, water and other metabolic waste blocks the perfusion of new 'food' to the cells. Lactic Acid clears relatively quickly (in a matter of a couple of hours or less), but many of the elements in Metabolic Waste can take a much longer time, so long that soreness can increase or even onset up to 48 hours later. Thus, clearing these elements quickly and efficiently through improved and energized venous return is essential for healthy cell prolferation and activity."

Now, I'm just a lawyer, so I don't pretend to understand any of that. But here's what I can say, after having these for two weeks: you'll have to pry them off of my cold, dead legs. Since I've had them, I've done my best to destroy myself through training, putting in two weeks of ~25 hours of quality training, including a 127-mile ride, 4-hour trainer ride, 20-mile run, 3:23 marathon, 1.5 hours/day on the Elliptigo, 2x/week Computrainer workouts, 3x/week swims, 3x/week yoga sessions, and 2x/week hard track workouts. And yet, after all of that, I can honestly say that I've never felt stronger. Three days after the Marine Corps Marathon, I had the best track practice I've ever had, and I followed it up today with the strongest Computrainer session I've had this year. You can bet I'm wearing the boots while I'm typing this. Thus, although my evidence is purely anecdotal, I have every reason to think that regular use of the boots has helped me handle a training load that otherwise I might not have. N.B. also was eager to take a turn in them after her 139-mile bike adventure, and generally fights me for them whenever possible, which I take to be an endorsement.

Aside from "feels great" and "seems to work," the final thing I'll mention about the boots is that they're convenient. One significant drawback of ice baths is that they're time-consuming, but using the Recovery Pump really doesn't take much time out of the day -- you can catch up on Jon Stewart, surf the web, pay bills, write blog posts, or even nap while you're using them. And, significantly, the system is highly portable. Although the boots look (and are) large when they're fully inflated, here they are deflated:

Beyond the boots, the entire system comprises the comrpessor box, pneumatic tubes, and a power cable. Here's a picture of the compressor box next to a paperback book:

Recovery Pump compressor and book for comparison.

As you can see from the picture below, everything together is a surprisingly compact package:

Compressor, boots, and cables.

This, to me, is one of the great benefits of the system: it easily fits into a suitcase or duffel bag, so I'll bring it with me to use in the days before and after races, like Ironman Cozumel later this month.

Having sung the praises of the system, I should mention two drawbacks. The first is relatively minor: the boots are warm. There's no air circulation in them, and for hygenic reasons (your legs can sweat a bit), the instructions direct users to wear long paints, such as track pants, and socks when using the system. Thus, when I take them off, I find that my legs are often a little bit sweaty, and if you use them in a hot room, it can be minorly uncomfortable at times. I've rarely had a problem with it.

The bigger drawback is the price. The list price of the system is $1395, although they're currently available at the introductory rate of $1195. (Using coupon code A11018, or purchasing one using the link on the right side of this blog, will get you a $25 discount, free ground shipping, and a complementary tote bag.) No two ways about it, the system is expensive. I'd submit, though, that among expensive triathlon-related things, the return on investment is very high, although perhaps not quite on the level of the Computrainer, which I've been addicted to for six years. Put it this way: for the price of two Zipp wheels, you could get two Reynolds or Hed wheels that are likely just as fast, and a Recovery Pump as well. You also could get a Recovery Pump using the money you'd save by selecting Ultegra instead of Dura-Ace components on a bike. Based on on my experience so far, I would certainly make either of those trade-offs in order to get one of these things. (For perspective, it's worth noting that the only marketplace competitor for Recovery Pump, the Normatec MVP, retails for $4,850.) It's also worth noting that, if the recovery benefits help to avoid injuries that require medical treatment or physical therapy, it could be less expensive than it looks.

In any case, there is some good news on the price front. Because the Recovery Pump system is a prescription-only, FDA-approved medical device, you can purchase one pre-tax using a Health Savings Account or equivalent. If you're wondering what to do with your expiring funds before year-end, I couldn't think of anything more worthwhile. [Edit: Since I wrote this review, the device has ceased to require a prescription.]

In short, as is obvious, I'm kind of in love with these things. Check 'em out!